The present invention relates to an apparatus for laser surgery on a patent lying on an operating table, and in particular to an apparatus for the treatment of eyes with lasers.
Most known apparatuses for treating eyes with lasers are constructed in such a manner that the person to be treated is seated. Although the head of the person to be treated is held by a head support, and in particular a chin support during the treatment, it is unavoidable that the person to be treated shows signs of fatigue during long treatment, as required, by way of illustration, in radial keratotomy.
For that reason it is suggested that the person to be treated be laid on a bed or an operating table during treatment in order that the patient is treated in a prone position and, therefore, in a much more relaxed state.
In a known apparatus for laser eye surgery, the laser is situated beside the bed or operating table. The laser beam is guided by a "boom" to the site to be treated, and in particular the eye. The observation device is attached to the boom. By way of illustration, this observation device can be an operation microscope for example.
The known apparatuses for laser eye surgery have a number of disadvantages. The laser, typically measuring 1.5 m.times.0.5 m.times.1 m, is situated at a short distance from the operating table in such a manner that the surgeon's freedom of movement is restricted. Furthermore, the attachment of the operation microscope to the boom does not permit the freedom of movement desired in specific cases of application. Also, the manner of directing the light by means of a boom does not allow the desired freedom to adjust the operation laser beam.
An object of the present invention is to provide an apparatus for laser surgery on a patient lying on an operating table, and in particular for laser treatment of the eye, whereby the laser beam is guided to the site to be treated without encumbering the surgeon, and which permits the necessary adjustment.
These objects are achieved in accordance with the present invention by providing an apparatus for laser surgery which includes a laser device situated under an operating table. Further, a beam guiding device is positioned in proximity to the side of the table for guiding the beam from the laser device to an operating site.
In this manner, the laser device which may be in the order of 1.5.times.0.1.times.1 m as discussed above, does not restrict the freedom of movement or the available space in the treatment room.
In advantageous features of certain preferred embodiments of the invention, the beam guiding device includes a vertical guiding element in proximity to the side of the operating table. In certain preferred embodiments of the invention, the vertical guiding element is attached to a longitudinal side of the operating table.
In other advantageous features of certain preferred embodiments of the invention, particularly for laser treatment of the eye, the vertical guiding element is attached to the longitudinal side of the table in the area of a patient's chest. In all of these embodiments, the freedom movement of the surgeon and eventual assistants is practically not restricted.
In certain preferred embodiments, the use of a pivot arm, from the end of which the laser emerges and whose length is adjustable, allows any possible adjustment of the point of impact of the laser beam.
In other advantageous features of certain preferred embodiments of the invention, so-called micro-manipulators or lighting devices of any design can be fitted in the pivot arm for precisely adjusting the point of impact of the laser beam, for example by tilting a mirror.
Of course, the table may be designed in a customary manner, for example being adjustable in height and/or tiltable. In any case, however, in other advantageous features of certain preferred embodiments of the invention, the pivot arm, out of which the laser emerges, is adjustable in height in such a manner that the distance between the point of emergence of the laser and its point of impact can be adjusted easily.
The invented manner of guiding the beam easily permits the fitting of a slit lamp in the apparatus in certain preferred embodiments of the invention, by way of illustration for eye operations. By way of illustration, the slit lamp can be fitted in the pivot arm, and the laser beam can be led through the slit lamp. Of course, it is also possible to provide a slit lamp which can be swivelled about an additional or the same axis as the pivot arm. Examples of slit lamps which could be used are shown in the following commonly assigned German priority applications, all filed in Germany on June 29, 1985, which are hereby incorporated by reference: P 35 23 341.9 (filed in U.S. as designated office for PCT Application No. PCT/DE 86/00268 on Mar. 2, 1987); P 35 23 342.7 (filed in U.S. as designated office for PCT Application No. PCT/DE 86/00265 on Mar. 2, 1987); and P 35 23 340.0 (filed in U.S. as designated office for PCT Application No. PCT/DE 86/00267 on Mar. 2, 1987).
In other advantageous features of certain preferred embodiments of the invention, an observing device is provided for observing surgery. In certain preferred embodiments, it is advantageous when the observation device is attached to an additional pivot arm (an observation pivot arm). By this observation pivot arm, an independent degree of freedom is permitted in adjusting the observing device in such a manner that, by way of illustration, the surgical operation can be observed from a given specific angle to the emitted laser.
In certain other preferred embodiments of the invention, the observation pivot arm, to which the observation device is fitted, further increases the possible adjustments of the observation device. For example, the observation pivot arm can be pivotable about a longitudinal axis of a vertical column which supports the observation pivot arm. The observation pivot arm can be further adjusted in height along the vertical column.
In other advantageous features of certain preferred embodiments of the invention, the observation pivot arm is provided with a plurality of bent portions. These bent portions can include additional pivot joints.
In other advantageous features of certain preferred embodiments of the invention, the observing device includes an operation microscope.
In other advantageous features of certain preferred embodiments of the invention, an operating table is included in the apparatus. The operating table includes longitudinal sides parallel to a patient lying on the table. The longitudinal sides are bevelled around the area of the patient's head.
Other objects, advantages and novel features of the present invention will become apparent from the following detailed description of the invention when considered in conjunction with the accompanying drawings.